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Background: Modern dentistry has increasingly valued conservative and biologically less invasive clinical practices, seeking to preserve the patients' tissues and natural dental elements. Most extractions in the dental clinic are preceded by periodontal disease that presents bone and gingival tissue loss, compromising the aesthetics as well as the support of dental elements. Objectives: The clinical approach in these cases often involves bone exertion followed by the successful installation of osseointegrated implants. Material and Methods: In this study, a case of extensive periodontal involvement and mobility of dental elements was carried out in a minimally invasive way, using the Er:YAG laser for periodontal decontamination and the hemolasertherapy technique to regenerate adjacent tissues, totaling nine weeks of treatment. Results: Clinical and radiographical improvement of tissue health and complete preservation of dental elements were observed. Conclusion: The patient underwent a follow-up appointment 2 years after the start of treatment when it was still possible to verify the stability of the clinical condition and the tissue gains obtained.
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Lasers de Estado Sólido , Humanos , Lasers de Estado Sólido/uso terapêutico , Feminino , Masculino , Gengiva/efeitos da radiação , Terapia com Luz de Baixa Intensidade , Pessoa de Meia-Idade , AdultoRESUMO
Objective: The aim of the current study was to use the CIELab system to evaluate the performance of the whitening treatment involving violet light-emitting diode (LED) combined with a home 10% and 22% carbamide peroxide dental bleaching technique on dental enamel. Methods: Fifty blocks of bovine dental enamel were divided into five groups: control group (control), receiving only LED irradiation; Whitening 10%, receiving 10% carbamide peroxide treatment; Whitening 10%+VL, receiving 10% carbamide peroxide treatment combined with LED irradiation; Whitening 22%, receiving 22% carbamide peroxide treatment; and Whitening 22%+VL, receiving 22% carbamide peroxide treatment combined with violet LED irradiation. Color tests were performed before the protocols, after 1 week and after 2 weeks of treatment by using a spectrophotometer and the CIELab parameters: L*, (a*) and (b*). The Whitening 10%, Whitening 10%+VL, Whitening 22% and Whitening 22%+VL groups were submitted to 10% and 22% carbamide peroxide 8 h per day for 14 days, whereas the Control was only stored in artificial saliva. For irradiation in the Control, Whitening 10%+VL, and Whitening 22%+VL groups, we used violet LED at a wavelength of 405-410 nm activated for 60 permanent seconds and 30 sec of pause once per week. As all data exhibited normal distribution, the comparisons were performed by using two-way repeated-measures analysis of variance. A post hoc t-test was employed, followed by the Ryan-Holm stepdown Bonferroni procedure. Results: After 1 week, the Whitening 22%+VL group differed significantly from all other groups in relation to hue, while no difference was found between the remaining groups (p < 0.05). Analyzing lightness, the Whitening 22%+VL and Whiteness10%+VL groups differed from the other groups (p > 0.05). In the 2nd week, the Whitening 22%+VL groups differed significantly from all other groups (p < 0.05) in hue, chroma, and lightness. The comparative analysis of bleaching times within the same group revealed significant differences in the Whitening 22%+VL group between baseline and week 1, baseline and week 2, as well as weeks 1 and 2 in terms of hue (p > 0.05). In the Whitening 22%+VL group, significant differences (p < 0.05) were found between baseline and week 2 as well as between weeks 1 and 2 in chroma (p > 0.05). In the Whitening 22%+VL group, statistically significant differences (p < 0.05) were found between baseline and week 1, baseline and week 2, as well as between weeks 1 and 2 in lightness. In the Whitening 10%+VL group, statistically significant differences (p < 0.05) were found between baseline and week 1, between baseline and week 2, as well as between weeks 1 and 2 in lightness. Conclusions: Tooth whitening treatment involving 10% and 22% carbamide peroxide combined with violet light promoted changes in the three axes of color (ΔH, ΔC, and ΔL) of the specimens evaluated. The use of the gel bleach alone was more efficient when the higher concentration was used. When violet light was combined with the gel, the lower concentration was more efficient.
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Clareadores Dentários , Clareamento Dental , Animais , Peróxido de Carbamida , Bovinos , Cor , Clareadores Dentários/farmacologiaRESUMO
Objective: The aim of this study was to analyze the microhardness of demineralized enamel following different treatments (fluoride varnish, Er:YAG laser, and Er:YAG laser associated with fluoride varnish). Methods: Forty-eight enamel blocks (4 × 4 × 7 mm) were divided into six groups (n = 8): (S) Sound; (DE) Demineralized; (DED) DE + Duraphat® 5% (fluoride varnish); (DEL20) DE + Er:YAG laser (20 mJ pulse mode; 0.20 W; 10 Hz; 60 sec; 1.18 J/cm2; 11.83 W/cm2); (DEL50) DE + Er:YAG laser (50 mJ pulse mode; 0.50 W; 10 Hz; 60 sec; 2.95 J/cm2; 29.58 W/cm2); (DEL20D) DE + Er:YAG laser (20 mJ) + Duraphat 5%. The irradiation was performed at 1 mm distance from the surface using a tip (AS7066X, L-14 mm, D-1.3 mm in diameter) in water/air spray refrigeration (level 6). The enamel blocks were submitted to pH cycling (4 h into DES solution +20 h into RE solution for 8 days and the solutions were changed every day). Knoop microhardness was measured (50 g/15 sec, six readings per sample) and data were analyzed by Kruskal-Wallis test at 5% significance. Results: After treatments, DF group showed higher microhardness values than all the groups. Also, DEL20D group showed similar results with H group according to the microhardness analysis (p < 0.05). Conclusions: It could be concluded that Duraphat 5% treatment showed better results when compared with all tested groups, however, the association of Er:YAG Laser 20 with Duraphat 5% also showed promising results.
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Lasers de Estado SólidoRESUMO
Introduction: Microleakage has been reported to cause dentin hypersensitivity because of the passage of bacteria and their products through the restoration-tooth interface and is one of the main reasons for replacement of restorations. CO2 laser can be used for treatment of dentin hypersensitivity. Thus, this study aimed to evaluate in vitro the microleakage in composite restorations following surface pretreatment with acid etching and CO2 laser. Methods: Twelve human caries-free primary molars were selected. Class II cavities were prepared on occlusal mesial and occlusal distal surfaces. Specimens were randomly divided into four groups (n=6): Group 1 (G1) - 37% phosphoric acid gel etching + Beautiful-Bulk Restorative - Giomer (Shofu Inc); Group 2 (G2) - 37% phosphoric acid gel etching + SDR Bulk-Fill Flow (Dentsply); Group 3 (G3) - CO2 laser irradiation + Beautiful-Bulk Restorative - Giomer (Shofu Inc); Group 4 (G4) - CO2 laser irradiation + SDR Bulk-Fill Flow (Dentsply). Surfaces were restored with bonding agent (Natural Bond DE, DFL). Specimens were cut longitudinally and immersed in 0.5% methylene blue solution for 4 hours. Microleakage scores were assessed under a magnifying glass at x3,5 and qualitatively analyzed by scanning electron microscope (SEM). Data were analyzed using nonparametric Wilcoxon test (P < 0.05). Results: Scores prevailed between 0 and 2, however, no statistically significant difference was found among the groups (P = 0.05). Conclusion: It could be concluded that all composite resins bulk fill did not show significant difference among them regarding microleakage using either CO2 laser or 37% phosphoric acid etching.
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INTRODUCTION: In-office tooth whitening treatment using violet light emited diode (LED) (405 nm) is a novel bleaching method that causes less sensitivity while offering the same effectiveness as the gold standard (35% hydrogen peroxide, H2O2). This study describes a protocol for the first randomised controlled clinical trial to compare the effects of the two methods. METHODS AND ANALYSIS: Eighty patients will be divided into four groups: G1 violet LED; G2 violet LED +35% carbamide peroxide; G3 35% H2O2 and G4 violet LED +gingivoplasty. Colour will be measured at baseline, immediately after the first session and at the 15 and 180 days follow-up using the Vita Classical and the digital Easyshade V spectrophotometer (Vita, Zahnfabrik, Germany). Sensitivity after whitening will be measured using the Visual Analogue Scale at baseline and at each session in all groups and in all follow-ups. The tissue removed during gingivoplasty (G4) will be submitted to immunohistochemical analysis for the determination of inflammatory changes caused by violet LED. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) will be evaluated before, as well as at established time point controls. The results will be expressed as mean and SD values. After determining the normality of the data, a one-way repeated-measures analysis of variance will be used for the comparison of data with normal distribution and the Kruskal-Wallis test will be used for data with non-normal distribution. A p<0.05 will be considered indicative of statistical significance. After determining the normality of the data, the Kruskal-Wallis test will be used for non-parametric data. Multivariate analysis of variance (MANOVA) and the Wilcoxon test will be used for comparing data from the PIDAQ. ETHICS AND DISSEMINATION: This protocol has been approved by the Human Research Ethics Committee of UniversidadeNove de Julho (certificate: 2.034.518). The findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT03192852; Pre-results.
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Sensibilidade da Dentina/etiologia , Peróxido de Hidrogênio/uso terapêutico , Fototerapia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Clareadores Dentários/uso terapêutico , Clareamento Dental/métodos , Peróxido de Carbamida/uso terapêutico , Cor , Gengivite/etiologia , Gengivite/patologia , Gengivoplastia , Humanos , Peróxido de Hidrogênio/efeitos adversos , Fototerapia/efeitos adversos , Clareamento Dental/efeitos adversos , Clareadores Dentários/efeitos adversos , Escala Visual AnalógicaRESUMO
BACKGROUND: Interdental papilla is of major importance to patients' orofacial aesthetics, especially regarding anterior teeth as part of the smile's harmony. Loss of gingival tissue, which constitutes interdental papilla, forms what in odontology is called black spaces. This loss, besides affecting the smile's aesthetics, also provokes phonetic and functional damage. OBJECTIVE: The objective of the authors is to present the result of three clinical cases treated with an innovative technique called hemolasertherapy, which stimulates growth of gingival papilla and thus permanently fills in the black spaces. METHODS: The photobiomodulation therapy (PBMT) used a 660 nm diode laser (Laser Duo, MMO-São Carlos, SP, Brazil), punctual, contact mode in two steps: before the bleeding (first PBMT) and immediately after bleeding (second PBMT). Parameters used were power output: 100 mW, CW; diameter tip: 5 mm; spot area: 0.19 cm2; irradiation exposure time per point: 20 sec; 14 points per daily session; total of 2 sessions, with a 1-week interval; E: 2 J per point; E: per daily session, 28 J; irradiance per point: 0.52 W/cm2; fluence per point: 10.4 J/cm2. Total in two daily sessions: total energy: 56 J; total fluence: 294.75 J/cm, 560 sec total time. An in vitro preliminary study was simultaneously carried out to demonstrate what could happen at cellular level in hemotherapy clinical cases associated with PBMT laser application. RESULTS: This initial study demonstrated that the blood clot originated from the bleeding provoked in the gingival area is rich in mesenchymal stem cells. PBMT enables preservation, viability, and further differentiation, stimulating the return of gingival stem cells, which would support their survival and differentiation in the blood clot, thus favoring interdental papilla regeneration. CONCLUSIONS: Follow-up was done for a time span of 4-5 years and considered excellent with regard to papilla preservation.
Assuntos
Facetas Dentárias , Gengiva/efeitos da radiação , Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade , Regeneração/efeitos da radiação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: One of the limiting factors of employing laser radiation on dental therapies is the potential of causing thermal injuries to pulp tissues. The purpose of this study was to evaluate intra-chamber temperature increase on extracted human teeth exposed to 670 nm wavelength InGaAlP laser diode radiation. MATERIALS AND METHODS: In vitro intra-chamber temperature measurements of 12 standardized human teeth (incisors, canines, premolars, and molars; n = 3) were taken both before and after laser radiation. A type-K thermocouple fast-response thermocouple wire with a 0.5 mm diameter probe was inserted into the tooth pulp chamber (ICEL-Manaus-brand). The laser device Lasotronic-brand InGaAlP laser diode was used to irradiate tooth enamel, perpendicularly to the external surface for 30 sec, with power of levels of 340, 272, 204, 136, and 68 mW. The measurements were taken at three time points: 0, 30 sec, and 3 min after the laser irradiation. Measurements were repeated 24 h after removal and reinsertion of the probe in the pulp chamber. The temperature gradient (ΔT in °C) was calculated (ΔT = final temperature-initial temperature) for each group. Data of ΔT were statistically analyzed by two-way analysis of variance (ANOVA) at the 95% confidence level and compared by Tukey post hoc test (α = 0.05). RESULTS: ANOVA showed statistically significant differences to the interaction of factors (p < 0.05). The highest ΔT values obtained were observed to incisors with 340 mW, 272 mW; 204 mW of power (respectively 4.7°C, 4.2°C, and 3.1°C); and canines presented the lowest ΔT (0.8°C-0.3°C) with no influence of power output. CONCLUSIONS: Since the thermal increase was observed in this study, especially in incisors, attention should be paid to avoid pulpal damage.
Assuntos
Cavidade Pulpar/efeitos da radiação , Lasers Semicondutores , Terapia com Luz de Baixa Intensidade/métodos , Temperatura , Análise de Variância , Dente Pré-Molar/efeitos da radiação , Humanos , Técnicas In Vitro , Incisivo/efeitos da radiaçãoRESUMO
O propósito deste estudo foi avaliar a efetividade do clareamento dentário através da análise instrumental da cor utilizando fotografias digitais. 54 pacientes foram divididos em três grupos: GI (peróxido de hidrogênio a 35%+ LED), GII (peróxido de hidrogênio a 35%+cálcio) e GIII (peróxido de hidrogênio a 15%+ LED). A cor foi aferida de forma instrumental, através de um espectrofotômetro (VITA Easyshade) e de fotografias digitais (programa Adobe Photoshop) e subjetiva, com as escalas VITAPAN Classical e VITA 3D Master. Foram realizadas duas sessões de clareamento e todos os protocolos seguiram as recomendações dos fabricantes dos produtos. Foi aplicado um questionário visual de avaliação de sensibilidade dentária como forma de validar a segurança dos tratamentos. Os grupos foram comparados pelo teste t de Student, com nível de confiança de 95% (p < 0,05), ANOVA e teste de Tukey. Os resultados dos valores de CIELab* não apresentaram diferenças estatisticamente significativas para L*(p = 0,68) e b*(p = 0,09), mas sim para a*(p < 0,01) na comparação entre a análise da cor aferida pelas fotografias digitais e o espectrofotômetro. Em todos os grupos houve uma redução significativa no tom amarelado (∆b) e aumento da luminosidade (∆L) demonstrando a efetividade do clareamento. Houve maior sensibilidade no Grupo I (p = 0,002). A aferição da cor através de fotografias digitais se constituiu em um instrumento adequado para avaliar a efetividade do clareamento dentário quando comparada com o espectrofotômetro. No entanto deve ser utilizada em conjunto com outros métodos de mensuração já consolidados na rotina clínica...
The purpose of this study was to evaluate the effectiveness of tooth bleaching by instrumental color analysis using digital photographs. 54 patients were divided into three groups: GI (hydrogen peroxide 35% + LED) GII (hydrogen peroxide 35% + calcium) and GIII (hydrogen peroxide 15% + LED). The color was assessed in instrumental form, through a spectrophotometer (VITA Easyshade) and digital photos (Adobe Photoshop program) and subjective, with the scales VITAPAN Classical and VITA 3D Master. There were two sessions of bleaching and all protocols followed the recommendations of the manufacturers of the products. A visual evaluation questionnaire of tooth sensitivity as a way to validate the safety of the treatments was applied. The groups were compared using the Student t test, with a confidence level of 95% (p <0.05), ANOVA and Tukey test. The results of the CIELab* values showed no statistically significant differences in L* (p = 0.68) and b * (p = 0.09), but to a * (p <0.01) when comparing the analysis of color measured by digital photographs and the spectrophotometer. In all groups there was a significant reduction in yellowness (∆b) and increased brightness (∆L) demonstrating the effectiveness of whitening. There was more sensitive in Group I (p= 0.002). Gauging the color using digital photography became an appropriate tool to evaluate the effectiveness of tooth whitening as compared with the spectrophotometer. However it should be used in conjunction with other measurement methods already established in clinical routine...
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Humanos , Masculino , Feminino , Clareamento Dental/métodos , Clareamento Dental , Espectrofotômetros/métodos , Fotografia Dentária/métodos , Fotografia DentáriaRESUMO
The aim of this work was to verify the existence of correlation between Raman spectroscopy readings of phosphate apatite (~960 cm-1), fluoridated apatite (~575 cm-1) and organic matrix (~1450 cm-1) levels and Diagnodent® readings at different stages of dental caries in extracted human teeth. The mean peak value of fluorescence in the carious area was recorded and teeth were divided in enamel caries, dentin caries and sound dental structure. After fluorescence readings, Raman spectroscopy was carried out on the same sites. The results showed significant difference (ANOVA, p<0.05) between the fluorescence readings for enamel (16.4 ± 2.3) and dentin (57.6 ± 23.7) on carious teeth. Raman peaks of enamel and dentin revealed that ~575 and ~960 cm-1 peaks were more intense in enamel caries. There was significant negative correlation (p<0.05) between the ~575 and ~960 cm-1 peaks and dentin caries. It may be concluded that the higher the fluorescence detected by Diagnodent the lower the peaks of phosphate apatite and fluoridated apatite. As the early diagnosis of caries is directly related to the identification of changes in the inorganic tooth components, Raman spectroscopy was more sensitive to variations of these components than Diagnodent.
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Cárie Dentária/diagnóstico , Esmalte Dentário/química , Dentina/química , Durapatita/análise , Lasers Semicondutores , Análise Espectral Raman , Análise de Variância , Apatitas/análise , Fluorescência , Fluorometria , Humanos , Compostos Orgânicos/análise , Estatísticas não Paramétricas , VibraçãoRESUMO
The aim of this work was to verify the existence of correlation between Raman spectroscopy readings of phosphate apatite (∼960 cm−1), fluoridated apatite (∼575 cm−1) and organic matrix (∼1450 cm−1) levels and Diagnodent® readings at different stages of dental caries in extracted human teeth. The mean peak value of fluorescence in the carious area was recorded and teeth were divided in enamel caries, dentin caries and sound dental structure. After fluorescence readings, Raman spectroscopy was carried out on the same sites. The results showed significant difference (ANOVA, p<0.05) between the fluorescence readings for enamel (16.4 ± 2.3) and dentin (57.6 ± 23.7) on carious teeth. Raman peaks of enamel and dentin revealed that ∼575 and ∼960 cm−1 peaks were more intense in enamel caries. There was significant negative correlation (p<0.05) between the ∼575 and ∼960 cm−1 peaks and dentin caries. It may be concluded that the higher the fluorescence detected by Diagnodent the lower the peaks of phosphate apatite and fluoridated apatite. As the early diagnosis of caries is directly related to the identification of changes in the inorganic tooth components, Raman spectroscopy was more sensitive to variations of these components than Diagnodent.
O objetivo desse estudo foi verificar por meio da espectroscopia Raman, a existência de correlação entre os níveis de apatita fosfatada (∼960 cm−1), apatita fluoretada (∼575 cm−1) e matriz orgânica (∼1450 cm−1) e as leituras do Diagnodent® em diferentes estágios de cárie dental em dentes humanos extraídos. O valor médio do pico de fluorescência na área da cárie foi anotado e os dentes divididos em cárie de esmalte, dentina e dente hígido. Após as leituras de fluorescência, foi realizada a espectroscopia Raman nos mesmos sítios. Os resultados mostraram diferença significante (ANOVA p<0,05) entre as leituras de fluorescência para esmalte (16,4 ± 2,3) e dentina (57,6 ± 23,7) nos dentes cariados. Os picos Raman para esmalte e dentina evidenciaram que os picos ∼575 e ∼960 cm−1 foram mais intensos em cárie de esmalte. Houve correlação negativa e significante (p<0,05) entre os picos ∼575 e ∼960 cm−1 e cárie de dentina. Pode-se concluir que quanto maior a fluorescência detectada pelo Diagnodent menor o pico da apatita fosfatada e fluoretada. O diagnóstico precoce da cárie está diretamente relacionado com a identificação de mudanças nos componentes inorgânicos do dente, assim a espectroscopia Raman foi mais sensível para variações desses componentes quando comparada ao Diagnodent.
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Humanos , Cárie Dentária/diagnóstico , Esmalte Dentário/química , Dentina/química , Durapatita/análise , Lasers Semicondutores , Análise Espectral Raman , Análise de Variância , Apatitas/análise , Fluorescência , Fluorometria , Compostos Orgânicos/análise , Estatísticas não Paramétricas , VibraçãoRESUMO
Dentinal surfaces prepared with an Er:YAG laser have distinctly different characteristics compared to those prepared with conventional instruments. The objective of this study was to evaluate the shear bond strength of a total-etch adhesive system and a self-etch adhesive system to dentin, prepared conventionally or with an Er:YAG laser. Specimens that were prepared with a diamond bur and treated with the total-etch adhesive showed the highest mean bond strength, followed by specimens prepared with the laser and treated with the total-etch adhesive, specimens prepared with a diamond bur and treated with the self-etch adhesive, and specimens prepared with the laser and treated with the self-etch adhesive, but there were no differences among the groups (P > 0.05). These data indicate that the tested adhesive systems promote similar shear bond strengths, whether the dentin is prepared with a diamond bur or an Er:YAG laser, and that an Er:YAG laser is a suitable cavity preparation method that promotes an adequate surface for a posterior adhesive procedure.
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Colagem Dentária , Adesivos Dentinários/química , Dentina/efeitos da radiação , Lasers de Estado Sólido , Condicionamento Ácido do Dente/métodos , Compostos Inorgânicos de Carbono/química , Resinas Compostas/química , Materiais Dentários/química , Análise do Estresse Dentário/instrumentação , Diamante/química , Etanol/química , Humanos , Teste de Materiais , Metacrilatos/química , Fosfatos/química , Ácidos Fosfóricos/química , Cimentos de Resina/química , Resistência ao Cisalhamento , Compostos de Silício/química , Estresse Mecânico , Temperatura , Fatores de Tempo , Preparo do Dente/instrumentação , Preparo do Dente/métodos , Água/químicaRESUMO
The simultaneous need for infection-control protocols in sample preparations and for safe laser irradiation parameters prompted this study about the effects of heat produced by both sample sterilization and laser etching on dentin components. The dentin was exposed on 30 bovine incisors, and then divided into two main groups: autoclaved (group A) or thymol treatment (group B). The surface of the dentin was schematically divided into four areas, with each one corresponding to a treatment subgroup. The specimens were either etched with phosphoric acid (control-CG) or irradiated with Er:YAG laser (subgroups: I-80 mJ, II-120 mJ, and III-180 mJ). Elemental distribution maps were done by energy-dispersive X-ray fluorescence (µ-EDXRF) on each treatment area. The dentin surface in depth was exposed and line-scan maps were performed. The B_CG treatment produced the best distribution of calcium (Ca) and phosphorus (P) content throughout the dentin surface. Er:YAG laser etching produced irregular patterns of elemental distribution in the dentin. Laser energies of 120 and 180 mJ produced the highest maximum calcium values. The Er:YAG laser energy of 180 mJ produced a localized increase in Ca and P content on the superficial layer of the dentin (â¼ 0-0.10 mm). The autoclaving treatment of samples in experiments is not recommended since it produced damaging effects on dentin components. Er:YAG laser irradiation produced a heterogeneous Ca and P distribution throughout the dentin surface with areas of increased Ca concentration, and this may affect clinically the permeability, solubility, or adhesive characteristics of dental hard tissues with restorative procedures.
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Corrosão Dentária/métodos , Dentina/química , Dentina/efeitos da radiação , Lasers de Estado Sólido , Animais , Cálcio/análise , Bovinos , Preparo da Cavidade Dentária , Temperatura Alta , Fósforo/análise , Espectrometria por Raios X , Propriedades de SuperfícieRESUMO
Failures in the sealing of the tooth apex have been considered to be responsible for most of the failures of apical surgeries. The Er:YAG laser has been proposed as an alternative for the use of rotator instruments in surgical endodontics due to its precision, lack of vibration, less post-operative discomfort, bacterial reduction, and less stress for patients and professionals. Following approval by the ethics committee, 12 extracted human canines without previous endodontic treatment with anatomically normal roots and free from apical lesions were washed in running tap water and disinfected. The teeth were sectioned axially at the crown-root junction and submitted to routine endodontic treatment. The apical limit was set at 1 mm before the apical foramen. The root canals were routinely filled with Gutta-Percha points and Sealer 26 and were randomly distributed into two groups (n = 6). In group I, apicectomy was performed with the Er:YAG laser (KAVO KEY Laser II®, Germany, λ = 2.940 nm, pulsed mode, 2051 tip, with air spray cooling, 250 mJ/15 Hz). Apical cut was performed of perpendicular mode 3 mm from the apical foramen. In group II, the same procedures and the same sequence as above was used, varying only the parameters of the Er:YAG laser (400 mJ/6 Hz). Sealing of the cervical end the apex was carried out with acrylic resin; the roots were covered by a layer of epoxy glue and two layers of nail polish. The specimens were divided into groups and fixed, by the cervical third, on wax. Impermeabilization of the residual root apical third was performed following the same procedures used in the cervical third but the residual apex was left free from the impermeabilization. After that, the roots were immersed in a 2% methylene blue solution and placed in a bacteriological oven for 48 h and then washed in running tap water for 2 h. The samples were sagittally split into two parts. The segments were visually observed and the one showing the greatest level of dye leakage was selected and kept in an individual container and coded accordingly. Apical staining was measured using a stereoscopic magnifying glass, a compass, and a caliper. The measurement was performed by three endodontists, previously calibrated, and unaware of the sample coding. The results showed that group I showed the greatest level of dye leakage. There was a significantly difference between the groups (p = 0.001). It is concluded that the apicectomies carried out with 400 mJ/6 Hz showed the smallest infiltration value.
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Apicectomia/instrumentação , Infiltração Dentária/cirurgia , Lasers de Estado Sólido/uso terapêutico , Apicectomia/métodos , Infiltração Dentária/prevenção & controle , Odontologia/métodos , Endodontia/instrumentação , Endodontia/métodos , Estudos de Viabilidade , Humanos , Estatísticas não ParamétricasRESUMO
OBJECTIVES: We aimed to assess through Raman spectroscopy and fluorescence the levels of calcium hydroxyapatite (CHA) and lipids and proteins in complete fractures treated with internal rigid fixation (IRF) treated or not with laser phototherapy (LPT) and associated or not with bone morphogenetic proteins (BMPs) and guided bone regeneration (GBR). BACKGROUND: Fractures have different etiologies and treatments and may be associated with bone losses. LPT has been shown to improve bone healing. METHODS: Tibial fractures were created on 15 animals and divided into five groups. LPT started immediately after surgery, repeated at 48-h intervals. Animal death occurred after 30 days. RESULTS: Raman spectroscopy and fluorescence were performed at the surface. Fluorescence data of group IRF + LPT + Biomaterial showed similar readings to those of the group IRF-no bone loss. Significant differences were seen between groups IRF + LPT + Biomaterial and IRF + LPT; IRF + LPT + Biomaterial; and IRF + Biomaterial; and between IRF + LPT + Biomaterial and IRF. CH groups of lipids and proteins readings showed decreased levels of organic components in subjects treated with the association of LPT, biomaterial, and GBR. Pearson correlation showed that fluorescence readings of both CHA and CH groups of lipids and proteins correlated negatively with the Raman data. CONCLUSIONS: The use of both methods indicates that the use of the biomaterials associated with infrared LPT resulted in a more-advanced and higher quality of bone repair in fractures treated with miniplates and that the DIAGNOdent may be used to perform optical biopsy on bone.
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Proteínas Morfogenéticas Ósseas/uso terapêutico , Regeneração Tecidual Guiada , Terapia com Luz de Baixa Intensidade , Análise Espectral Raman , Fraturas da Tíbia/terapia , Animais , Materiais Biocompatíveis , Placas Ósseas , Regeneração Óssea/fisiologia , Terapia Combinada , Masculino , Coelhos , Fraturas da Tíbia/metabolismo , Fraturas da Tíbia/cirurgia , CicatrizaçãoRESUMO
A crescente demanda por um sorriso branco e saudável associada à introdução de novos materiais e técnicas, resultou em uma evolução significativa na Odontologia estética. Dentre os tratamentos mais procurados pelos pacientes, o clareamento de dentes vitais realizado em consultório - também chamado de clareamento assistido - tem sido amplamente utilizado e consiste na utilização de géis de peróxido de carbamida ou hidrogênio em alta concentração. A principal vantagem dessa técnica são os significativos resultados estéticos alcançados em poucas sessões, com curta duração. No entanto, a técnica requer do Cirurgião-Dentista conhecimento técnico-científico e cuidados especiais, não apenas com as estruturas de esmalte e dentina, como também com os tecidos moles da cavidade bucal. Este artigo tem como objetivo abordar aspectos importantes da técnica que auxiliarão o profissional na sua realização em consultório. Serão abordados estudos que descrevem as indicações da técnica, bem como os que discutem os seus benefícios e limitações, apresentando aspectos científicos importantes para a prática clínica.
Within the most requested treatments, in-office dental bleaching has been widely in- dicated and consists on the use of high concentrated carbamide and hydrogen peroxides (25-38%). The main advantage of the technique is the significant esthetic results that can be achieved in few clinical sessions with a short period of exposure of the bleaching agent to the dental surface. However, the in-office bleaching requires from the professional some technical and scientific skills and specific care not only with enamel and dentin structures but also with the surrounding soft tissues. This manuscript aims to address important topics that will help professionals in their day-by-day clinic. Studies related to the in-office technique, its benefits and limitations will be discussed and important scientific information will be highlighted in order to guide the clinical practice.
Assuntos
Humanos , Masculino , Feminino , Clareamento Dental/métodos , Esmalte Dentário/anatomia & histologia , Estimulação Luminosa/métodosRESUMO
Objetivo: O propósito deste estudo in vitro foi avaliar a interface resina f dentina de restaurações Classe V após condicionamento com laser de Er:YAG. Material e Métodos: Cento e vinte terceiros molares humanos extraídos foram divididos em oito grupos (A 1, A2, A3, M, L 1, L2, L3 e L 4) n= 15. Cavidades Classe V foram preparadas com broca na superfície vestibular. Nos grupos L 1, L2, L3 e L 4, a dentina e o esmalte foram irradiados com laser de Er:YAG (15 Jfcm2). Após o condicionamento ácido os grupos A 1, A2, L 1 e L2 foram restaurados com Prime & Bond NT® e resina composta Esthet X® e os grupos A3, M, L3 e L4 com Single Bond® e resina composta Z25()®. Os grupos A 1, A3, L 1 e L3 foram polimerizados com luz halógena e os grupos A2, M, L2 e L4 com laser de argônio. Os espécimes foram preparados para o teste de mi- croinfiltração marginal e para a análise através de microscopia eletrônica de varredura. Resultados: Houve diferenças estatisticamente significativas entre os grupos (p< 0.05). Os menores valores de microinfiltração foram encontrados nos gruposA3 (±0.40) e L4 (±0.80). As fotomicrografias dos gruposA3, L3 e L4 mostra- ram uma superfície polida e um adequado selamento entre o material e o dente. Conclusão: Este estudo sugere que um sistema adesivo composto de HEMA, etanol e água poderia ser empregado com vantagens na adesão à dentina após o condicionamento com laser de Er:YAG. No entanto, outros estudos usando diferentes formulações químicas são necessários antes de uma recomendação para uso clínico.
Objective: The aim of this study was to assess the resin f dentin interface of Class V restorations after Er:YAG laser etching. Matherial and Methods: One hundred twenty extracted human third molars teeth were divided into eight groups (A 1, A2, A3, M, L1, L2, L3 and L4) n= 15. Class V cavities were prepared with bur on the vestibular surfaces. However, in groups L1, L2, L3 and L4, dentin and enamel surfaces were irradiated with Er:YAG laser (15 Jfcm2). After acid etching groups A 1, A2, L 1 and L2 were restored with Prime & Bond NT® and composite resin Esthet X® and groups A3, M, L3 and L4 with Single Bond® and composite resin Z25()®. GroupsA 1, A3, L 1 and L3 were light cured by current visible light and groups A2, M, L2 and L4 with an argon laser. The specimens were routinely processed for the microleakage test and SEM analysis. Results: There were statistically significant differences among groups (P< 0.05). The lower microleakage values were found in groups A3 (±0.40) and L4 (±0.80). The photomicrographs of groups A3, L3 and L4 showed a smooth surface and an adequate seal between material and tooth. Conclusion: This study suggested that a hema, water/ethanol based adhesive system could be applied with advantages for the bonding to dentin after Er:YAG laser etching, but further studies using different chemical formulations are needed before clinical use can be recommended.
Assuntos
Humanos , Masculino , Feminino , Dentina/anatomia & histologia , Lasers de Estado Sólido/uso terapêutico , Cárie Dentária/patologia , Restauração Dentária Permanente/métodosRESUMO
OBJECTIVE: The aim of this multidisciplinary study was to evaluate quantitatively and qualitatively the effect of a 660-nm diode laser in the prevention and treatment of human oral mucositis (OM) in patients suffering from head and neck cancer who had undergone radiotherapy and chemotherapy. BACKGROUND DATA: OM is a severe oral lesion resulting from the toxic effects of treatment for cancer in the head and neck region. Low-level laser therapy is indicated to prevent and treat this oral complication and may be used alone or in association with conventional drug treatment, producing pain relief and wound repair. METHODS: This study included 72 patients with head and neck cancer treated at the Cancer Hospital of Mato-Grosso, Brazil, and divided into a control group (C; n = 36) and a laser group (L; n = 36). Laser therapy was performed in combination with radiotherapy and chemotherapy twice a week using a diode laser (lambda = 660 nm, power = 30 mW, spot size = 2 mm, energy = 2 J per point). RESULTS: Statistically significant differences were observed between the two groups. Patients in group L usually did not present with OM or pain, but all patients in group C presented with OM ranging from Level I to III associated with pain. This difference was significant from week 1 on, increased until week 4 and remained stable up to week 7. CONCLUSION: Laser therapy was effective in preventing and treating oral effects induced by radiotherapy and chemotherapy, thus improving the patient's quality of life.
Assuntos
Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Lesões por Radiação/prevenção & controle , Lesões por Radiação/radioterapia , Estomatite/prevenção & controle , Estomatite/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Estomatite/induzido quimicamente , Estomatite/etiologiaRESUMO
The effects of laser etching, decontamination, and storage treatments on dentin components were studied using Fourier transform (FT)-Raman spectroscopy. Thirty bovine incisors were prepared to expose the dentin surface and then divided in two main groups based upon the decontamination process and storage procedure: autoclaved (group A, n=15) or stored in thymol aqueous solution (group B, n=15). The surfaces of the dentin slices were schematically divided into four areas, with each one corresponding to a treatment subgroup. The specimens were either etched with phosphoric acid (control subgroup) or irradiated with erbium-doped yttrium-aluminum-garnet (Er:YAG) laser (subgroups: I-80 mJ, II-120 mJ, and III-180 mJ, and total energy of 12 J). Samples were analyzed by FT-Raman spectroscopy; we collected three spectra for each area (before and after treatment). The integrated areas of five Raman peaks were calculated to yield average spectra. The areas of the peaks associated with phosphate content (P<0.001), type I collagen, and organic C-H bonds (P<0.05) were reduced significantly in group A (control). Analyses of samples irradiated with reduced laser energies did not show significant changes in the dentin components. These results suggest that thymol storage treatment is advised for in vitro study; furthermore, 12 J of Er:YAG laser energy does not affect dentin components.